Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

How Long Will You Live? A New Set of Assessment Tools May Be Able to Tell

January 15th, 2012 at 4:54 pm by timigustafson
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Researchers at the University of California, San Francisco (UCSF) have come up with new assessment tools to determine the likelihood of death within a certain period of time.

For this, they established a number of prognostic indices to predict the life expectancy in older and terminally ill patients. The main purpose of this project is to provide doctors, care givers as well as patients and their family members with information that can help prevent overtesting and overtreatment.

The UCSF team has also posted an interactive website online, called “ePrognosis.org,” which can be used to calculate a person’s mortality risk based on specific data, including age, health conditions, cognitive status, functional ability, etc.

“This is the first time such tools have been assembled for physicians in a single online location,” wrote Paula Span of the New York Times who reported on the project (1/11/2012) after a review was published in The Journal of the American Medical Association last week.

Among experts, responses have so far been mostly positive. “This kind of synthesis is very helpful for [health care] providers, researchers and some patients,” said Dr. Susan L. Mitchell, a geriatrician at Harvard University and researcher at Hebrew SeniorLife in Boston who was quoted in the Times article.

“A more frank discussion of prognosis in the elderly is sorely needed,” said Dr. Sei Lee, a geriatrician at UCSF and one of the authors of the review. A more accurate assessment of a patient’s life expectancy could help doctors and families evaluate, for example, whether an older person with a terminal disease should continue receiving treatments that may cause more pain and discomfort than relief, according to Dr. Lee. It may also be useful in determining how vigilant a patient has to be in observing and maintaining certain treatment- and lifestyle measures.

Since no calculation of life expectancy – other than based on data collected by U.S. Census Bureau – has so far existed, there is now hope that relatively easily accessible assessment tools like ePrognosis will be able to better assist health care providers with their decision making process.

In fact, many clinical decisions for older and terminally ill patients include considerations of life expectancy. But “at present, physicians are often shooting in the dark when they recommend tests, treatments and medications for older patients. […] Even when interventions do work, the benefits can be years away. Doctors have no easy way to know whether their elderly patients will live long enough to experience them. The potential for complications and side effects, however, is immediate,” wrote Ms. Span.

While it is true that with declining life expectancy some treatments may do more harm than good, it is not altogether clear whether accurate predictions can ever be made for an individual patient, cautioned Dr. Kenneth Covinsky, professor at the Department of Medicine, Division of Geriatrics at UCSF. “The accuracy of prognostic indices is often tested under ideal and controlled conditions,” he said. “When you see a research report of a prognostic index, you see how well it did in a group of patients specified by the researchers. But how accurate will the index be in your patient? […] Your patients are never quite the same as the patients in the research study.”

As a prognostic aid, programs like ePrognosis may turn out to be quite valuable, “if used to supplement clinical judgment,” said Dr. Covinsky. “Clinicians (and patients too) now have easy access to these prognostic indices. […] But perhaps the danger of ePrognosis is that it is too easy. In a matter of minutes, you can input a few elements of patient data and the calculator will spit out a probability of survival,” he added.

Some critics have pointed out that the very idea of basing decisions in medical care on calculations such as these may be a slippery slope. They say that assessing a patient’s life expectancy should never be the starting point of any form of treatment. Dr. Lee freely admitted there are potential problems. Because it is not clear whether calculating prognostic indices will ultimately improve patient care in clinical settings, he said, the researchers stopped short of urging widespread use at this time, according to the Times.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Gourmet Dining on a Slowing Metabolism

January 11th, 2012 at 1:08 pm by timigustafson
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Today’s retirees have many more options how to spend their golden years than any generation before them. Baby boomers, especially those who are well off, can satisfy their curiosity and adventurous spirit by exploring new business endeavors, continuing their education or traveling around the world. Some discover new passions and acquire new skills they never had time for while working.

One of those late pursuits that is rapidly gaining in popularity is gourmet dining, both at home and at restaurants. Interest in advanced cooking classes has never been greater, not to mention the high ratings for food shows and competitions between celebrity chefs on TV. The auditoria of culinary institutes around the world are filled with students in their sixties, seventies and beyond, eager to familiarize themselves with the latest trends and techniques in the world of haute cuisine.

Fine wining and dining has always been a prerogative of those who like (and can afford) to indulge in the better things life has to offer, but today it’s a whole different ballgame. In an article for the New York Times (12/28/2011), Charles Isherwood, a food writer, describes his parents (both retired) as “foodies” for whom eating well has become their lives’ mission. “My parents practically live to eat,” he writes. “At home [they] eat out three or so times a week. But when they come to New York, we sample the city’s restaurants in five-day, two-big-meals-a-day binges that have become something of a legend.”

Of course, besides being tremendously pleasurable, fine dining also conveys an aura of culture and sophistication (not to mention exclusiveness due to oftentimes ridiculous pricing). However, many food lovers also seem to think that eating at the best restaurants or cooking with the most expensive ingredients automatically means their diet is healthy. But this is not necessarily true.

Gourmet chefs typically focus on taste and presentation. Calorie counts and fat contents are not their primary concern. The individual portions may look small compared to lower-end eateries with their “all-you-can-eat” value offers, but if you order three, four or more courses, you end up with a similarly large amount of food in your stomach.

You may say, well, it’s only on rare occasions that you go all out like that. But what about eating out three times a day when you travel? What about a cruise where limitless access to great food is one of the perks?

The unfortunate truth is that as you get older and have more time and funds to indulge a little more than you used to, your metabolism begins to slow down. In fact, it slows down about 5% to 10% every decade or so, beginning in your mid-twenties. This means that the typical American loses between 20% and 40% of metabolic power over the course of his or her lifespan, according to Dr. John Berardi, best-selling author of “The Metabolism Advantage.”

The reasons are easy to understand: Your metabolism converts calories into energy. When your calorie intake is higher than your energy expenditure, weight gain occurs. As you grow older, it becomes harder to maintain a healthy calorie-energy balance because your lifestyle probably becomes more sedentary and your physical activities get less strenuous. Another result is age-related muscle loss. Diminishing muscle mass means that fewer calories are being burned off and your metabolism slows down. While this is an inevitable, natural process, there are things you can do to prevent it from happening too fast.

The best way to counteract muscle loss is weight training. Lifting weights does not only add muscle, it also burns off calories even while you rest afterwards. Doing aerobics, of course, also helps with calorie burn. People who are said to have a faster metabolism are probably just more physically active all day.

Not surprisingly, adherence to healthy eating habits also matters more with age. Your calorie requirements may go down, but your need for high-quality nutrients remains the same throughout your life. Simple but nutrient-dense foods are the best choices for a healthy, age-appropriate diet – such as fresh fruits and vegetables rich in antioxidants, whole grains, fish, lean meats and low-fat dairy products.

So, before you try out your next culinary sensation downtown or at home, keep in mind that your health is too important to throw all caution to the wind, just because you can.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Signs of Memory Loss Found in Younger People

January 8th, 2012 at 3:25 pm by timigustafson
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Loss of memory and other cognitive functions may start much earlier in life than previously thought, according to a clinical study from England. A modest decline of mental abilities such as reasoning and problem-solving was found in participants who were only in their forties.

For the study, researchers tested 7,000 men and women over a period of 10 years for memory, vocabulary and aural and visual comprehension. The results showed an average of 3.6 percent decline in reasoning skills in both sexes at the age of 45 to 49. 65 to 70 years old men showed on average a steeper decline than women of the same age group – 9.6 versus 7.4 percent.

Since the youngest participants were 45 years old when the study began, it is possible that the deterioration of brain functions may commence even earlier, according to Dr. Archana Singh-Manoux, the leader of the research, which was co-sponsored by the Center for Research in Epidemiology and Population in France and the University College London. The results were recently published in the “British Medical Journal.”

Previous studies on age-related decline of mental health have primarily focused on people in their sixties, seventies and beyond. By limiting ourselves to a narrower scope, we may not yet have gotten the entire picture, according to Dr. Singh-Manoux. A decline of mental capacity doesn’t suddenly happen at old age. That variability exists much earlier on, she says.

Researchers still need to learn more about the risk factors that lead to progressive cognitive impairment. There is strong evidence that Alzheimer’s disease and other forms of dementia is closely related to heart disease, which is typically caused by weight problems, high blood pressure and high cholesterol.

We probably underestimate how affected the broader population may be, says Dr. Singh-Manoux. The participants in this study were drawn from a relative homogeneous pool of office workers who were well educated and, for the most part, enjoyed a comfortable life and good health. This is not necessarily a representative profile at a time when so many suffer from obesity and other lifestyle-related health issues.

Although the causes of mental decline are not yet fully understood, experts recommend a number of measures that may not prevent but at least slow down the process. These include regular physical exercise, healthy nutrition, weight control, intellectual activity, avoidance of smoking and alcohol/drug abuse, stress reduction, sufficient amounts of sleep as well as social activities and supportive relationships.

A study conducted by the Mayo Clinic concluded that engaging in stimulating mental activities through reading, discussion, playing challenging games and other interactions can help decrease the risk of cognitive impairment significantly. This does not only apply to the elderly. To prevent even mild cognitive impairment (MCI), it is important to “exercise” the brain at any age.

“This study… demonstrates that aging does not need to be a passive process,” says Dr. Yonas Geda, a Mayo Clinic neuropsychiatrist and lead author of the study report. “By simply engaging in cognitive exercise, you can protect against future memory loss.”

To what degree we actually hold the key to our mental health remains to be seen. Preserving our physical health as best as we can is certainly a good strategy. Baby boomers have long been spending millions to save their sagging skin, fix their crow’s feet and plump their lips. As they reach old age, they finally are beginning to turn to brain boosters to fight memory loss, writes Virginia Anderson of WebMD in an article titled “Seven Brain Boosters to Prevent Memory Loss.” In fact, the process may begin much earlier in life and people need to pay attention before it’s too late.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Sometimes, the Best Way to Lose Weight Is a Change of Venue

January 4th, 2012 at 1:30 pm by timigustafson
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Taking time off for health purposes is not yet as common in America as it is in Europe where indulging in week-long spa treatments is considered a part of health care and is often covered by insurance. But that is changing. Inspired by TV shows like “The Biggest Loser,” which is taped at a facility in Malibu, California, named “The Ranch,” weight loss and fitness getaways are becoming increasing popular here as well.

Of course, fitness resorts have been around for a long time, especially in California, but today’s versions are much more intense and physically demanding. Gone are the days where “women padded around in slippers and pink robes, eating low-calorie meals from vegetables grown in the backyard and engaging in calisthenics and leg lifts,” writes Jennifer Conlin, a frequent contributor to the New York Times “Travel” section (1/1/2012), as she reports about her own experiences at one of the “Biggest Loser” resorts.

Retreats specializing in weight loss and fitness now call their programs “university,” “camp” or even “boot camp.” Nobody should expect a relaxing time when signing up for daily three-hour exercise classes, six-hour hikes and evening lectures on wholesome nutrition, lean cooking styles and lifelong weight management.

While this may not sound like a dream vacation, business is booming. In fact, demand is growing fast across all age groups despite of the sweat, pain, hunger, exhaustion and also the oftentimes extremely high costs involved. A week-long stay can set you back between two and eight thousand dollars. In return you get unlimited use of workout facilities, personal coaching, counseling sessions, three small but healthy meals, lots of education and, best of all, unconditional support from everyone around you.

The latter may be what makes these retreats most attractive – and most useful. Absence of a supportive environment ranks among the most common reasons for relapsing after weight loss. Team spirit, being in it together and sharing goals can do wonders for people who struggle with weight issues. By contrast, feeling isolated, ashamed, misunderstood or pitied can quickly sabotage their best efforts.

Having a well-functioning support system of family and friends can give your weight-loss efforts a big boost, says Jennifer R. Scott, who writes as a weight loss guide for About.com. “When you become truly committed to your weight loss journey, it’s perfectly reasonable – and necessary – to ask your loved ones to become committed with you.” This, of course, is not always easy. In truth, she says, the people closest to you can be your greatest “weight-loss saboteurs.” They may even add more roadblocks to your struggles. Your spouses or friends who have weight problems themselves may feel “left behind” if you succeed at losing weight and they don’t. Feelings of insecurity, jealousy and envy may arise. Or, they may feel imposed upon when asked to go along with certain changes. That’s why it can be helpful to choose a different venue as you try out new lifestyle choices, at least in the beginning.

If a “boot camp” is not your style, or you just can’t get away for long, or the expenditures are prohibitively high, you may want to consider more feasible alternatives.

You can find some face-to-face contact with like-minded “losers” who help you stay focused on your goals right in your backyard, says Scott. For instance, your local hospital may have a wellness- or lifestyle center where you can join classes and support groups for free. Or you can sign up for a “wellness plan” that gives you access to therapy facilities and other health care packages. Commercial weight loss programs often include meetings with fellow-participants in your community. And then there is still the good old YMCA/YWCA, offering classes, seminars and memberships in a vast variety of interest groups.

If all else fails, you can start your own “health club” by inviting friends, neighbors and colleagues who have similar intentions. What matters most is that you get the support you need to succeed, and that can come from many places.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

This Year Could Be Different

December 29th, 2011 at 2:05 pm by timigustafson
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What is it with New Year’s resolutions that makes them so prone to failure, it’s almost ludicrous to think of making another one? You know how it goes: This year, it will be different! I can change! I will stick to my plans and see them through, no matter what! No more excuses! And then, a few weeks later (if that long), things fall apart again and everything is back to “normal.”

If this scenario sounds familiar to you, you are not alone. Just one week into the new year, a quarter of resolutionists will have given up, according to Tom Connellan, author or the “1 Percent Solution – How to Make Your Next 30 Days the Best Ever.” In his estimation, about 90 percent of all the promises people make to themselves are forgotten as time moves on.

So, let’s be honest: New Year’s resolutions may be a time-honored tradition, but you shouldn’t take them too seriously. Old habits don’t break easily. Stop beating yourself up and face reality. It’s not going to be different this time – or will it?

One of the main reasons why our best intentions often fail is that we rely too much on our own resolve, says Connellan. People falsely believe that they can make big changes if they are sufficiently motivated. But nothing could be further from the truth. “People only think in large terms that are often unrealistic – like losing lots of weight or making a major life change. [They] don’t realize that even positive change is uncomfortable,” he says.

The trick is not to overestimate your abilities but to accept your limitations and to begin by taking small steps in the right directions. That doesn’t mean you’re giving up on your ambitions or lose sight of your larger goals. It just means you have to find better ways to go about them.

Be aware that there is no such thing as a clean slate or a brand new start when it comes to lifestyle changes. You are who you are. Everyone brings baggage. What matters most is not to let negative experiences of the past get in your way as you move forward.

People should not expect to become a “better person” by doing this, that or the other differently, say Judith Matz and Ellen Frankel, both clinical therapists, real-life sisters and bestselling coauthors of the “Diet Surviver’s Handbook” and “Beyond a Shadow of a Diet.” “Instead of making resolutions, a better way to go is, every day, cultivate healthy practices in your life that enhance your overall being physically, emotionally and spiritually.”

In other words, don’t compartmentalize. If your goal is to lose some weight, you should also look at the larger picture. You don’t just want to get rid of a few pounds, you want to be more healthy, fit and energetic. Healthy eating and exercise will get you there, but you also need a mindset that is conducive to an all-around healthy lifestyle.

So instead of going on another dreaded diet regimen, come up with realistic resolutions this year. Forget your futile attempts and failures of the past. They only make you apprehensive and fearful of more failures. “Visualize success,” advises Shirley Archer, a fitness and wellness instructor. “How would you look and feel and what would you be able to do if you enjoyed your ideal fitness?” “Don’t be too vague or too large,” she advises, when you set out your goals. While anyone can start a diet or fitness program at any time, in her experience, it takes approximately two months for a person to change his or her mindset and make new habits stick. A few weeks of dieting and exercising may let you lose some weight, but you need a larger scope to become a healthy person, she says.

This year could be different if you take the right approach. You can choose to become the person you envision as your ideal and make the necessary changes. Or you can try once again to patch up things the way you did before, hoping for a different outcome. This is as good a time as any to decide which way you want to go. Happy New Year!

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Surviving the Travel Season

December 27th, 2011 at 11:29 am by timigustafson
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If you travel by plane over the holidays, there’s a good chance you’ll come back with an unpleasant souvenir, such as a cough, a runny nose or worse. Research has shown that air travelers suffer higher rates of infections than those using other means of transportation. In times of high volume travel, the likelihood of getting sick increases exponentially.

The crowded, confined spaces inside airplanes can turn into a breeding ground for a vast array of infectious diseases. Although most passenger jets have sophisticated filtration systems to keep airborne viruses from spreading – high-efficiency particulate air (HEPA) filters are said to capture over 99 percent of bacteria and virus-carrying particles – you still can get infected because you are in close proximity to the mouths, noses and hands of so many other people. Also, the air circulation usually gets shut down when passengers board or exit or while the plane waits for takeoff. It is during these time periods that infections can spread like wildfire.

The greatest danger comes from your immediate surroundings, like the seats in front, besides and behind you, according to a study published by the U.S. Centers for Disease Control and Prevention (CDC) in the journal “Emerging Infectious Diseases.” Viruses and bacteria can survive for many hours on the surfaces of seats, armrests, tray tables, remote controls and inside backseat pockets.

Your body’s natural defenses can also become compromised when you spend hours in a compressed cabin 30,000 feet up in the air. “When mucous membranes dry out [because of extremely dry air in airplanes], they are far less effective at blocking infections. High altitude can tire the body and fatigue plays a role in making people more susceptible to catching colds, too,” says Scott McCartney, a travel writer and author of “Where Germs Lurk on Planes.”

So, what can you do to protect your health while in transit? Travel expert Douglas Wright recommends to be especially aware of places where germs typically breed in a plane, including water tanks, food containers and lavatories.

Water quality on airplanes deserves more scrutiny than most passengers realize, according to Wright. People should be concerned about contamination of the water they drink in form of tea, coffee, cold water and ice cubes. Tests by the U.S. Environment Protection Agency(EPA) have found traces of E. coli in onboard water tanks in both domestically and internationally operating aircraft. Many of these tanks are refilled at foreign airports where water purity standards can be questionable, says Wright. His advice is to purchase sealed water bottles or other prepackaged liquids after clearing airport security and use those instead.

Even in-flight meals (including business- and first class) are not always beyond reproach. In 2009, the U.S. Food and Drug Administration (FDA) found that some airline catering companies had less than perfect preparation and handling standards (to put it mildly). “You never really know where your meal has been. If you’re concerned, eat beforehand and bring your own snacks,” warns Wright.

Not surprisingly, the lavatory is one of the airplane’s most hazardous germ zones. The CDC considered airplane lavatories a major danger area for the spread of diseases during the H1N1 flu and SARS epidemics. Instead of washing your hands with water from the lavatory faucet, Wright recommends to use your own hand sanitizer when returning to your seat.

Caution is also advised with regards to airline-issued pillows and blankets. Just because you find them sealed in a plastic bag does not mean they are new or have been freshly cleaned. The same goes for earphones. Although there is no evidence that passengers routinely fall ill from using these items, it is still not a bad idea to bring your own whenever possible.

No matter how many cautionary measures you are willing to take, there will always be a certain amount of risk involved when you travel – by whatever means. “Work, recreation and families have become global. Most of us have to fly,” says Dr. Judith Reichman, MD, medical advisor and contributor to “Today’s Women,” in an article titled “Germs on a Plane: Can You Get Sick Flying?” “With rare exceptions, we don’t risk serious illness. Simple hygiene, hydration and judgment can help prevent air related health problems,” she added.

Even so, there are a few precautionary measures worthwhile observing:

1. Boost your immune system by eating healthy and getting enough sleep. I also recommend taking vitamin supplements or an Airborne® tablet a few hours before travel time.

2. Stay hydrated at all times. If the quality of the water served on the plane is questionable, bring your own.

3. Clean your hands frequently with hand sanitizers, especially before touching food.

4. Disinfect tray tables, armrests and remote controls the moment you’re seated.

5. Bring your own pillow, blanket and earphones if possible.

6. Avoid using seat pockets.

7. Open the air vent above your seat and aim it directly in front of your face. It can help blow virus-carrying particles away from you.

8. Change seats, if at all possible, if you find yourself in close proximity to someone displaying cold or flu symptoms.

9. Alert crewmembers if the air circulation system does not work properly or is shut off for extended periods of time.

10. Do take all necessary precautions without becoming paranoid. If your health concerns cause you too much stress, it’s time to relax and rely on your natural immune system to do its job.

Bon voyage!

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

A Rickshaw for Your Living Room?

December 21st, 2011 at 1:41 pm by timigustafson
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While searching for a few more gift ideas for family and friends, I came across a catalog that seemed to specialize in items I had never considered or even seen before. A rickshaw for $2,200 from a company named “Anthropologie” got my attention. Not that I was about to buy a full-size rickshaw for myself or loved ones. None of us would have any good use for it. Also, the one in the catalog was obviously meant to be displayed in a home, like a piece of furniture or an art object rather than a means of transportation, although you could probably take it for a spin around the neighborhood a few times, if you were so inclined.

I understand that for the gift industry to come up with new ideas year after year must be extremely challenging. It takes true genius to invent things that are so attractive that people just can’t imagine living without them. Eventually, some of this is bound to venture into the absurd.

Don’t get me wrong. I think many of today’s popular gifts are great. I-pods, smart phones, tablets, video games (especially the ones that make you move) – I’m for all of that. I’m not opposed to nice possessions. I’ve had my share and still do. I don’t even have a personal aversion against rickshaws. Far from it. They hold plenty of dear memories for me. During my travels in India and China, rickshaw rides were often the fastest, cheapest and most convenient way to get around. Still, a rickshaw for the living room seems awfully forced.

In the movie, “The Bucket List,” which has become some sort of a cult movie among baby boomers, two cancer-ward roommates, one an insanely rich entrepreneur, the other a blue color worker (played respectively by Jack Nicholson and Morgan Freeman), decide to go off on a last around-the-world adventure before – well, before they kick the bucket. Even the billionaire realizes that money is all he has left and it won’t buy him what he wants the most – time. All he can do is fill his remaining days with as many meaningful experiences as possible. And he goes for it. Together with his unlikely companion he discovers what life has to offer beyond material wealth. And what a difference it makes.

I myself have long realized that my experiences and memories are the only things that have lasted in my life. Most of my possessions have come and gone. Even the homes I owned only exist now in my mind as places where we built our lives as a family, where my children grew up, where we entertained friends, where my dogs were raised and buried, where the seasons came and went, marking the rhythm of time. What’s completely absent from the picture are the knickknacks accumulated and then discarded.

So, here is what’s on my wish list now and hopefully for the rest of my life:

1. I want to love and be loved
2. I want to preserve my physical health for as long as possible
3. I want to stay mentally fit
4. I want to keep my curiosity and playfulness
5. I want to continue to be financially secure
6. I want to see my family happy, healthy and prosperous
7. I want to have at least one good belly laugh a day
8. I want to be free of negative emotions like fear, anger or bitterness
9. I want to be grateful, kind, forgiving and patient
10. I want to be useful and helpful for others
11. I want my work to make a difference for the better
12. I want to take a few more rickshaw rides in far-flung places

And I want to wish you, my dear readers, happy holidays and all the best for the coming year.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Your Drinks Count, Too

December 18th, 2011 at 5:40 pm by timigustafson
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Most people are well aware that they will probably gain some weight over the holidays from all the festive dinners and extra treats. They are less conscious of the fact that drinks, both alcoholic and non-alcoholic, can contribute just as much if not more to the expansion of their waistline. It’s hard to keep track of the extra calories from liquids because the brain doesn’t receive a “full” signal from the stomach the way it happens with solid food.

Especially drinking alcoholic beverages can significantly increase calorie intake with just a few shots or sips. Many liquors are as caloric as sugary sodas. Alcohol itself is high in calories – 7 calories per gram, more than carbohydrates or protein (4 calories per gram) and almost as much as fat (9 calories per gram). This applies just to straight drinks, like beer, wine and spirits. Cocktails with added ingredients can quickly multiply the calorie content.

“If you drink, even moderately, first you do need to acknowledge the calories. They count,” said Lona Sandon, a nutritionist at the University of Texas Southwestern School of Health Professions and spokesperson for the American Dietetic Association (ADA).

Keep in mind that calories from alcohol are “empty” calories, meaning they don’t contain any nutrients. The liver processes alcohol first to get rid of toxins, while other nutrients are put on hold. While alcohol is being metabolized, fat burning is suspended. Moreover, an increased alcohol level in your blood stream can make you feel hungry because it lowers your blood sugar. All of these factors combined are the perfect set-up for weight gain.

Another well-known fact is that alcohol diminishes one’s inhibition and self-control. That’s why the holidays are often a time when caution gets thrown to the wind with regrets to follow later.

Of course, not everyone who enjoys a drink or two develops weight problems. Scientists have not been able to consistently tie alcohol consumption to weight gain. Also, a person’s individual genetic make-up can greatly affect his or her body’s ability to process alcohol.

Gender can play a role as well. Researchers found that when men drink, they also tend to eat more food, thereby increasing their overall calorie intake through both. Women, on the other hand, are more likely to compensate for their drinking by eating less.

Naturally, it matters what kind of food or snacks you’re having with your drinks. Beer with pretzels or peanuts, or wine with cheese and crackers are popular combinations, but they can be deadly in terms of weight control.

Coffee drinks and seasonal spirits are not harmless either. Many are loaded with sugar and cream and a few gulps can quickly add up to a calorie count of a full meal. Eggnog, a traditional favorite, is a real heavy weight. A one-cup serving has about 400 calories – and who can just have one?

So, what can you do to avoid these calorie traps without spoiling your holiday spirit? Quite a bit, actually. For starters, don’t get caught off guard when alcoholic beverages are being served. If you like wine or beer, stick with it. Don’t mix with other drinks. If hard liquor is your poison, have it straight up, on the rocks or with club soda but without a lot of other stuff added. Be particularly careful with super-caloric cocktails. They are desserts in disguise. If you have eggnog or fruit punch, I recommend taking them “naked,” meaning no extra toppings like chocolate or whipped cream.

As with everything, moderation is key. If you have been reading my columns regularly, you know one of my favorite mottos: “Nothing is forbidden, but everything counts.” Observing this little piece of wisdom is even more important during the holiday season. Cheers!

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Reducing Risk Factors for Alzheimer’s Disease

December 14th, 2011 at 3:47 pm by timigustafson
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At an international conference, sponsored by the Alzheimer’s Association last July in Paris, researchers discussed the growing global risk of Alzheimer’s disease. It is estimated that 36 million people currently suffer from the disease worldwide. Predictions are that those numbers will triple by the mid-century.

Although the causes of Alzheimer’s disease are not yet fully understood, it is becoming increasingly evident that diet and lifestyle choices play a more significant role than previously thought. Altogether seven lifestyle-related risk factors were identified based on a new mathematical model that was developed by a research team from the University of California, San Francisco (UCSF).

They are: Physical inactivity (21 percent), depression (15 percent), smoking (11 percent), hypertension (8 percent), obesity (7 percent), low education (7 percent) and diabetes (3 percent). These risk factors combined are believed to contribute to about five and a half million cases of Alzheimer’s in the United States alone.

Based on findings such as these, the Alzheimer’s Association has pledged to fund more studies to explore the importance of mental and physical health for risk reduction and ultimately prevention of the disease.

One area on which researchers have been able to shed some light is the connection between Alzheimer’s and cardiovascular disease. Autopsy studies have shown that 80 percent of Alzheimer’s patients suffered from cardiovascular disease or related conditions like high blood pressure, heart disease, high cholesterol and stroke.

“Taking care of your heart protects your brain,” said Dr. Jack C. de la Torre, a leading researcher in the field. He believes that reducing cardiovascular risk factors as early as possible is key in the prevention of memory loss and dementia in later years. There is general agreement among the experts that a healthy, balanced diet and regular exercise are the most effective measures people can take to protect their mental health.

A study report from Rush Medical College in Chicago concluded that a Mediterranean-style diet, which is predominantly vegetarian and low in fat, may have positive effects on the brain as well. For this project, 3,790 men and women ages 65 and older were periodically tested over an average of 15 years for memory and thinking skills. The participants who adhered most strictly to the Mediterranean diet scored significantly higher in the tests and were diagnosed as two years younger in “brain age” in comparison to their counterparts who didn’t follow a particular diet regimen. The findings still held after adjustments were made for other risk factors like age, sex, race, education, etc.

The report, which was published in the American Journal of Clinical Nutrition, concluded that, although the research “could not account for all the many factors that may contribute to cognitive decline in old age, […] a Mediterranean diet helps cut down on inflammatory substances in the body.” Inflammation has long been tied to heart disease and now possibly to Alzheimer’s disease as well.

Key ingredients of the Mediterranean diet, which derives its name from the typical food choices in countries around the Mediterranean Sea, include an abundance of fresh fruits, vegetables, whole grains, nuts, legumes, olive oil and fish but only limited amounts of dairy products and meats.

The other equally important component of an anti-Alzheimer’s disease lifestyle is regular exercise. A study on the benefits of physical activity for mental health, published in the Archives of Internal Medicine, found that “regular exercise may be good for staying mentally sharp into old age.”

Particularly resistance training (weight lifting) was singled out as a highly effective form of exercise in a study from Vancouver, Canada. Participating seniors who engaged at least twice a week in weight lifting scored on average higher on mental acuity tests than those who did only aerobics.

Still, as other studies from the U.S. and Europe have shown, older men and women who follow a moderate to intense exercise regimen of any kind score regularly higher on cognitive tests than their sedentary contemporaries.

Alzheimer’s is a complex phenomenon. Understanding it enough to hope for better prevention, let alone a cure, requires much further studying, especially with regards to its genetic components. However, since lifestyle factors almost certainly play a major role, we all can start taking steps to do our part in preventing this terrible disease.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Quality of Life Is Part of Health Care

December 11th, 2011 at 5:38 pm by timigustafson
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Even people who decry European social policies as socialism or welfarism admit that countries like Sweden, France or Germany provide their citizens with benefits not commonly available in the United States in terms of access to health care, job security, unemployment aid, maternity leave, child day care, paid vacations and more.

While it is true that the U.S. spends more than most countries on health care, the average life expectancy is lower and infant mortality is higher here than in many other industrialized nations. Why the discrepancy?

Based on a study that compared the various health care policies of the 30 most developed countries in the world, researchers found that spending on health care combined with spending on social services made the most significant difference. The study report, which was published in the journal BMJ Quality and Safety, concluded that spending on social services can extend and improve people’s lives in ways that health care alone cannot achieve.

“We studied 10 years’ worth of data and found that if you counted the combined investment in health care and social services, the United States no longer spent the most money – far from it,” wrote Elizabeth H. Bradley, a professor for public health at Yale University, and Lauren Taylor, a program manager at Yale’s Global Health Leadership Institute, in a co-authored op-ed article in the New York Times (12/9/2011).

“America is one of only three industrialized countries to spend the majority of its health and social service budget on health care itself. For every dollar we spend on health care, we spend an additional 90 cents on social services. In our peer countries [mostly in Europe], for every dollar spent on health care, an additional $2 is spent on social services. So not only are we spending less, we’re allocating our resources disproportionately on health care,” they added.

Health experts agree that unmet social needs often lead to an increase in acute health problems. Like actual diseases, lack of health insurance, job insecurity and poverty contribute heavily to the worsening of our public health. For millions of Americans, the hospital emergency room is the only option left in an otherwise broken system, a last resort that is not really sustainable.

“It’s time to think more broadly about where to find leverage for achieving a healthier society,” wrote Bradley and Taylor. The simplest way would be to invest more in social services, like the Europeans do. But this would mean an extended role of government and probably higher taxes, both of which are considered non-starters in the current political climate.

Still, the authors insist that introducing variations of the European model may be possible at some point in the future. As an example where this is already happening they cite a program called “Stand Downs” by the Department of Veterans Affairs, which addresses a number of social needs of retired service members as part of their health care plan.

So, what can be done in the meantime for the rest of us? For once, we need a better understanding of the importance of pro-active instead of strictly re-active health care. While it is common knowledge that “an ounce of prevention is worth a pound of cure,” we have yet to turn these insights into action. Health education and counseling should be considered as important as drug prescriptions and surgery – and appropriately funded. The fact that many of today’s common diseases are caused by poor lifestyle choices, bad eating habits, stress and sleep disorders should make us rethink our health care priorities.

Furthermore, studies have shown how access to basic health care can give people peace of mind and improve their overall well-being and quality of life (as I have reported earlier in an article titled “Health Insurance Shown to Make a Big Difference in Quality of Life”). It is part of a safety net nobody should have to be without. Seeing so many people in our midst deprived of some of the most elementary social services is intolerable. We can and must do better.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

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About timigustafson

Timi Gustafson, RD, LDN, FAND is a registered dietitian, health counselor, book author, syndicated newspaper columnist and blogger. She lectures on nutrition and healthy living to audiences worldwide. She is the founder and president of Solstice Publications LLC, a publishing company specializing in health and lifestyle education. Timi completed her Clinical Dietetic Internship at the University of California Medical Center, San Francisco. She is a Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Dietetic Association, a member of the Diabetes Care and Education, Healthy Aging, Vegetarian Nutrition and the Sports, Cardiovascular and Wellness Nutrition practice groups. For more information, please visit http://www.timigustafson.com

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